Exam 1: LA Epidurals Flashcards
(17 cards)
Epidural: 2-Chloroprocaine [3%]
*Onset
*Duration
*Onset: 5-15 min
*Duration: 30-90 min
Epidural: Lidocaine [2%]
*Onset
*Duration
*Onset: 10-20 min
*Duration: 60-120 min
Epidural: Ropivacaine [0.75%]
*Onset
*Duration
*Onset: 15-20 min
*Duration: 140-220 min
Epidural: Bupivacaine [0.5%]
*Onset
*Duration
*Onset: 15-20 min
*Duration: 160-220 min
Epidural: Levobupivacaine [0.5%]
*Onset
*Duration
*Onset: 15-20 min
*Duration: 150-225 min
Epidurals: Fastest to Slowest Onset
2-Chloroprocaine -> Lidocaine -> Ropivacaine ->Bupivacaine -> Levobupivacaine
Epidurals: Shortest Duration to Longest Duration
2-Chloroprocaine -> Lidocaine->Ropivacaine -> Bupivacaine -> Levobupivacaine
Epidurals: What is Alkalinzation?
*Dose
Add NaHCO3 to LA
*1 meq/ 10 mL of LA
*Helps prolong and increase the pH
Epidurals: How do you calculate the Top Off Dose?
50% of the Initial Dose
Epidurals: How to Calculate Dosing
*Ex: Sensory Block at L4 reaching T8
*If I am using Lidocaine, when would I do a Top Off Dose and What would it be in this problem?
*1-2 mL per segment
*L4 to T8 is 8 Segments
*1-2 x 8 = 8-16 mL needed
*Lido - 60 minutes; Dose would be 4-8 mL
Top Off Dose Time: Lidocaine
60 min
Top Off Dose Time:
2-Chloroprocaine
45 min
Top Off Dose Time:
Mepivacaine
60 min
Top Off Dose Time:
Bupivacaine/Ropivacaine
120 min
What Factors Affect Spread of Epidurals? (5)
*Controllable
*Non-Controllable
LA Volume, Level of Injection, LA dose, Pregnancy, old age
*Controllable: Volume, level of injection, dose
*Non-Controllable: pregnancy, old age
What factors have a small-affect on spread?(3)
LA [], Pt position, Height (non-control)
What 3 controllable factors do not affect spread?
Additives in the LA, bevel direction, speed of injection
